11929 EVERGREEN WAY SWIFT STATION 2024-02-09

BODING PERMIT APPLICAON CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue orBlack Ink Only Please) .. PR ECT:SITE"INFORMATION PROJECT SITE ADDRESS: STREET SR 99 at Airport Rd /( 9 Z9 L-v¢.ryte.2N 417 PARCEL#: N/A cir Everett / STATE WA ZIP 98203 SUITE/UNIT#: N/A FLOOR#:N/A ADDITIONAL LOCATION INFORMATION (if applicable): Stop#2781 TENANT/BUSINESS NAME(if non-residential):NSA LEGAL DESCRIPTION for new construction: Short Plat/subdivision: N/A Lot No.: N/A (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Todd Jacobs (Community Transit) OWNER MAILING ADDRESS: STREET 7100 Hardeson Rd cm, Everett STATE WA ZIP 98203 OWNER PHONE:425-348-2367 OWNER EMAIL: toddjacobs@commtrans.org commtrans.org CONTRACTOR COMPANY NAME:Craig Wyman (Imagicorps) WA STATE CONTRACTOR LICENSE#(REQUIRED):IMAGII*012MF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 49398 CONTRACTOR ADDRESS: STREET 10500 231ST WAY NE cn-v Redmond STATE WA ZIP 98502 CONTRACTOR PHONE:425-869- +135 CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑✓ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:45_739-4242 Wind! S h a p l ey CONTACT EMAIL:windi.shapley@otak.com BUILDING INFORMATION , VALUATION OF WORK:$39,000 ASSOCIATED LAND USE PROJECT#(if applicable):N/A (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:BUS Station PROPOSED USE OF BUILDING:BUS Station HEAT SOURCE: ❑Gas ❑Electric ❑Other N/A BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑✓Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ✓❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑✓Other:Bus Shelter Windscreens and Railing DESCRIPTION OF WORK: Installation of new windscreens and railing at Community Transit Swift Blue Line bus Station #2781 at the intersection of Airport Rd and SR 99 ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 5 2Zb2 obZ® Windt A.Shapley Digitally signed by Wiedi A.Shepley Date:2022.02.07 11:43:10-01700' Owner/Authorized Agent Signature Date (Revised 2/8/2021)